Unnecessary health care

Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate.[1] In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012.[2]

Factors that drive overuse include paying health professionals more to do more (fee-for-service), defensive medicine to protect against litigiousness, and insulation from price sensitivity in instances where the consumer is not the payer—the patient receives goods and services but insurance pays for them (whether public insurance, private, or both).[3] Such factors leave many actors in the system (doctors, patients, pharmaceutical companies, device manufacturers) with inadequate incentive to restrain health care prices or overuse.[1][4] This drives payers, such as national health insurance systems or the U.S. Centers for Medicare and Medicaid Services, to focus on medical necessity as a condition for payment. However, the threshold between necessity and lack thereof can often be subjective.

Overtreatment, in the strict sense, may refer to unnecessary medical interventions, including treatment of a self-limited condition (overdiagnosis) or to extensive treatment for a condition that requires only limited treatment.

It is economically linked with overmedicalization.

  1. ^ a b Ezekiel J. Emanuel, Victor R. Fuchs (2008). "The perfect storm of overutilization" (PDF). The Journal of the American Medical Association. 299 (23): 2789–91. doi:10.1001/jama.299.23.2789. PMID 18560006. Archived from the original (PDF) on September 2, 2009.
  2. ^ Kliff, Sarah (September 7, 2012). "We spend $750 billion on unnecessary health care. Two charts explain why". The Washington Post. Archived from the original on December 30, 2015. Retrieved March 31, 2016.
  3. ^ Ezekiel J. Emanuel & Victor R. Fuchs (2008). "Health Care Overutilization in the United States—Reply". The Journal of the American Medical Association. 300 (19): 2251. doi:10.1001/jama.2008.605.
  4. ^ Cite error: The named reference Waste was invoked but never defined (see the help page).

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